Lunch will be served. Metered parking is available in the Botanic Gardens lot across the road from Beebe Hall. No registration or RSVP required except for groups of 5 or more. We ask that larger groups email Lori Biechele at lb274@cornell.edu letting us know of your plans to attend so that we can order enough lunch.

This semester we welcome speakers from across campus and across the U.S. for our spring 2017 Talks at Twelve series. Talks at Twelve are held in the Beebe Hall second floor conference room and lunch is served. These talks are free and open to all. No RSVP or registration is required, but notice is appreciated if a larger group is planning to attend (email pmt6@cornell.edu).

Research on the design of mental and behavioral health facilities is available but limited, although the shortcomings of these facilities are well-known. Dr. Mardelle Shepley will describe design features that are believed to positively impact staff, patients, and families in psychiatric environments and provide information related to their presence in existing facilities. Her research project involved both qualitative and quantitative methods. Dr. Shepley will share results involving a variety of topics including the appropriateness of private rooms, deinstitutionalization, access to nature, and open nursing station design. She will also provide guidelines for mental and behavioral health facilities.

Mardelle Shepley is a professor in the Department of Design and Environmental Analysis and associate director of the Institute for Healthy Futures. She serves on the graduate field faculty in the Department of Architecture. A fellow in the American Institute of Architects, she has authored/co-authored six books, including Healthcare Environments for Children and their Families (1998), A Practitioner’s Guide to Evidence-based Design (2008), Design for Critical Care (2009), Health Facility Evaluation for Design Practitioners (2010), Design for Pediatric and Neonatal Critical Care (2014) and Design for Mental and Behavioral Health (2017).

This talk is open to all. Lunch will be served. Metered parking is available in the Botanic Gardens lot across the road from Beebe Hall. No registration or RSVP required except for groups of 5 or more. We ask that larger groups email Patty at pmt6@cornell.edu letting us know of your plans to attend so that we can order enough lunch.

In a recent Time Magazine cover story on Anxiety, Depression and the American Adolescent, the BCTR's Janis Whitlock describes the effect of current technology and social media on adolescent mental health:

"If you wanted to create an environment to churn out really angsty people, we’ve done it,” says Janis Whitlock, director of the Cornell Research Program on Self-Injury and Recovery. Sure, parental micromanaging can be a factor, as can school stress, but Whitlock doesn’t think those things are the main drivers of this epidemic. “It’s that they’re in a cauldron of stimulus they can’t get away from, or don’t want to get away from, or don’t know how to get away from,” she says.

The academic study of this behavior is nascent, but researchers are developing a deeper understanding of how physical pain may relieve the psychological pain of some people who practice it. That knowledge may help experts better understand why it can be hard for some people to stop self-harming once they start. Whitlock, the director of the self-injury research program at Cornell, explains that studies are pretty consistent in showing that people who injure themselves do it to cope with anxiety or depression.

It’s hard to know why self-harm has surfaced at this time, and it’s possible we’re just more aware of it now because we live in a world where we’re more aware of everything. Whitlock thinks there’s a cultural element to it. Starting in the late 1990s, the body became a kind of billboard for self-expression—that’s when tattoos and piercings went mainstream. “As that was starting to happen, the idea of etching your emotional pain into your body was not a big step from the body as a canvas as an idea,” she says.

The idea that self-harm is tied to how we see the human body tracks with what many teens told me when I interviewed them. As Faith-Ann describes it, “A lot of value is put on our physical beauty now. All of our friends are Photoshopping their own photos—it’s hard to escape that need to be perfect.” Before the dawn of social media, the disorders that seemed to be the quintessential reflection of those same societal pressures were anorexia or bulimia—which are still serious concerns.

Whitlock says there are two common experiences that people have with selfharm. There are those who feel disconnected or numb. “They don’t feel real, and there’s something about pain and blood that brings them into their body,” she says.

On the other end of the spectrum are people who feel an overwhelming amount of emotion, says Whitlock. “If you asked them to describe those emotions on a scale of 1 to 10, they would say 10, while you or I might rate the same experience as a 6 or 7. They need to discharge those feelings somehow, and injury becomes their way,” she explains.

The research on what happens in the brain and body when someone cuts is still emerging. Scientists want to better understand how self-harm engages the endogenous opioid system—which is involved in the pain response in the brain—and what happens if and when it does.

Some of the treatments for self-harm are similar to those for addiction, particularly in the focus on identifying underlying psychological issues—what’s causing the anxiety and depression in the first place—and then teaching healthy ways to cope. Similarly, those who want to stop need a strong level of internal motivation.

Narayan Reddy gives a student's perspective on working with the BCTR's Cornell Research Program on Self-Injury and Recovery in a recent Cornell Daily Sun column. Reddy, a junior in the College of Arts and Sciences, discusses the ways that misogyny also negatively affects men, specifically in the realm of seeking mental health support. The full column:

I have been a research assistant for the Cornell Research Program on Self-Injury and Recovery, now known as the Youth, Risk and Opportunity lab, for a few years now. One of the projects I worked on last year was transcribing interviews. The interviews were conducted to clarify the course of one’s relationship with NSSI throughout one’s life as it relates to the trans-theoretical model. This model reflects an individual’s readiness to act on incorporating a healthier behavior into their lives, which in the cases of these individuals would be working towards ending their engagement in NSSI [non-suicidal self-injury].

The interviews themselves were of many perspectives. Some were teenagers who faced bullying, young adults struggling with their relationships and older individuals who confided in us that self-injury had been a fixture in their life for a long time. One thing they shared in common was their gender identity. All were women, with the exception of one young man.

No, this gender distribution is not representative of the overall population. Countless demographic studies on NSSI have consistently found that its prevalence is half women and half men. However, significantly less men seek treatment for their NSSI, or rather, the underlying mental health causes maintaining the behavior. It then follows that a large amount of men experiencing mental health issues do not seek treatment for them, and another body of research can confirm that the results of this negligence can be devastating.

This is one example of how sexism is damaging to men. The movement is entitled feminism because women comprise the gender seeking equality; they are the marginalized. It is a social-justice cause that has implications for better opportunities available to women by reforming a male-dominant system to allow for the realization of ambitions, aspirations, hopes, dreams and basic fundamental rights. However, it is often neglected that men are also affected by sexism in that many feel they must live up to the expectations that a male-dominant system entails. Stereotypically masculine features are those of strength, resilience and detachedness, being minimally emotional and stereotypically feminine features are the binary opposite: weakness, delicateness and affectedness, being overtly emotional.

American Male, a short film released by MTV, effectively illustrates the toxic effects a fragile masculinity can have. American because the United States is a country horribly beset by sexism, and the setting of a fraternity grounded in ‘bro’ culture is a specific aspect of American society in which such toxicity seeps into almost every conceivable social interaction.

“Order beer not wine.” “And beef not chicken. Never light beer though. And not tofu. Never tofu. Can’t get more gay than tofu.”

The narration of how to be a man eventually makes what is implicit explicit: directly comparing the social cues that define appropriate behaviors based on gender. As he recites the laws, they begin to touch on deeper levels of personal adjustment and consequently depict stronger repressions of emotional expression and vulnerability.

“Steer clear of the arts unless you live near the coasts. That means no theatre, dancing, painting, poetry or prose. Too much reading is also risky because it makes you look soft and bookish.”

“Women move their hips when they walk, men move their shoulders.”

“Women use exclamation points when they talk, men use periods.”

“Women second guess, men go with their gut.”

“Women write in diaries, men journal.”

“Women sing, dance and perform on stage. Men play sports, watch sports and talk about sports.”

As conversations about mental health are inherently discussed through emotions, men are as a result less likely to seek help for mental health issues they are experiencing. If an adolescent is engaging in NSSI, he may fear telling his friends or even his parents because he will lose any chance of cultivating an image of toughness; the fear of not living up to his manhood.

A similar phenomenon occurs with other areas of mental health, with one prevalent example being the stereotype of those suffering from eating disorders being exclusively young, middle to upper-class women with body image issues. Along with women, a large amount of men also suffer from eating disorders. Their causes are as diverse as the people who deal with them. For a man who shows symptoms of an eating disorder, however, their internalization of masculinity actively prevents them from receiving treatment. It is not a stretch to say that even the way in which NSSI usually presents between genders is also gendered. Women are more taken to forms of cutting, and men, punching. Furthermore, men are barred from participating in mental health research that also requires dialogue about emotions. This can explain the lack of information regarding mental health in men and the proceeding lack of mental health treatments that could be effective for male populations. This is a particularly troubling aspect of disparity out of the entire systemic issue of stigma that mental health advocacy is fighting to address.

In accordance with de-stigmatization, we must double down on efforts to have men be open up about their emotions, or just what they are going through in general, with feminism. This sentiment is related to the fundamental importance of fighting discrimination leveraged against women because of stereotypes surrounding their emotional states. It should be noted that women are not necessarily better off than men even in this aspect.

A woman’s openness about mental health issues is not only recognized, but is often perceived as signs of being over-exaggerators attention-seekers, and has in many cases led to speculations about her sexual promiscuity. This perception deems a woman’s mental health less worthy than a man’s, who is applauded for speaking up about his mental health, whereas it becomes deceptive when a women does it. This can be seen in the discussions of celebrities’ mental health, what separates Amanda Bynes, Tila Tequila, Kehlani and Lindsay Lohan from Kanye West, Ryan Adams and most recently Kid Cudi. To take on sexism in this regard, we must empower both genders and encourage men to be more open about mental health while at the same time discouraging biased reactions when women choose to be more open about theirs.

The man who narrates the short film ends it by describing himself as a chameleon, one who must constantly alter his presentation to fit his social environment. Ultimately, he admits to sacrificing his personhood in exchange for becoming a set of social cues. In one sense, however, being a chameleon can be a good thing in that it can represent both the dark shades associated with manhood, and the bright associated with womanhood, to display the full range of colors, the emotional expressions, that paint our existence as unique human beings removed from our gender expression. Consequently, we must all learn to be dysfunctional chameleons if we truly seek to improve access to and acceptability of mental health as well as the quality of mental health treatment.

The rush of self-esteem that comes with the ubiquitous thumbs-up has more people asking that question, as Facebook and other social media sites offer more ways for friends to endorse photos and posts.

But one group seems immune to that rush: people with a sense of purpose.

In the first study on the effects of purpose in the online world, Cornell researchers have found that having a sense of purpose limits how reactive people are to positive feedback on social media.

“We found that having a sense of purpose allowed people to navigate virtual feedback with more rigidity and persistence. With a sense of purpose, they’re not so malleable to the number of likes they receive,” said Anthony Burrow, co-author of the study and assistant professor of human development. “Purposeful people noticed the positive feedback, but did not rely on it to feel good about themselves.”

Burrow and other researchers define a sense of purpose as ongoing motivation that is self-directed, oriented toward the future and beneficial to others. People with a strong sense of purpose tend to agree with such statements as “To me, all the things I do are worthwhile” and “I have lots of reasons for living.”

While it is nice to receive compliments, online or otherwise, it may not be a good thing to base one’s self-esteem on them, Burrow said.

“Otherwise, on days when you receive few likes, you’ll feel worse. Your self-esteem would be contingent on what other people say and think,” he said. “Over time that’s not healthy, that’s not adaptive. You want to show up with rigidity: ‘I know who I am and I feel good about that.’”

The study, “How many likes did I get?: Purpose moderates links between positive social media feedback and self-esteem,” appeared Sept. 14 in the Journal of Experimental Social Psychology.

The researchers hypothesize that because purposeful people have the ability to see themselves in the future and act in ways that help them achieve their goals, they are able to inhibit impulsive responses to perceived rewards, such that they prefer larger downstream incentives to smaller immediate ones, said co-author Nicolette Rainone ’16.

The researchers conducted two experiments to get these results.

In the first, they recruited nearly 250 active Facebook users from around the country. They measured the participants’ self-esteem and sense of purpose, and asked how many likes they typically got on photos they posted.

The Facebook users who reported getting more likes on average also reported greater self-esteem. But those with a high level of purpose showed no change in self-esteem, no matter how many likes they got. “That is, receiving more likes only corresponded with greater self-esteem for those who had lower levels of purpose,” Burrow said.

In the second study, the researchers asked about 100 Cornell students to take a selfie and post it to a mock social media site, “Faces of the Ivies.” The students were told that their photo had received a high, low or average number of likes.

Getting a high number of likes boosted self-esteem – but, again, only for students who had less purpose. “In fact, those higher in purpose showed no elevation in self-esteem, even when they were told they received a high number of likes,” Burrow said.

This is the first study to show purpose lowers reactivity to positive events. Most research to date on purpose has looked at it as buffer against negative events such as stress.

Without a sense of purpose, one can act against one’s own interests even when something positive happens, said Rainone, who is a program assistant for the Program for Research on Youth Development and Engagement at Cornell’s Bronfenbrenner Center for Translational Research. “For example, if I’m studying for a big exam and get a good score on a practice test, that can make me think, ‘Oh, I really don’t need to study.’ And that may ultimately decrease my final score, because I stopped persisting,” she said. “Having a purpose keeps you emotionally steady which is essential for successful academic and work performance.”

The curriculum, aimed at individuals who interact with youths in school, community and clinical settings, as well as parents, offers research-based information paired with intervention and prevention strategies to address a phenomenon that is widespread but not yet fully understood.

“It’s a scary thing to encounter,” said Whitlock. “It’s just not your typical, run-of-the-mill risk behavior.”

Individuals practicing NSSI – upward of 15 percent of adolescents and young adults try it at least once – deliberately damage their bodies, for example by cutting, burning or carving their skin or punching objects or themselves to inflict harm. Whitlock cites 15 to 17 percent lifetime prevalence of NSSI among Cornell students, according to surveys.

Although the surface wounds may look like suicide attempts, Whitlock pointed out that NSSI is, in fact, a coping mechanism for individuals trying to deal with intense feelings or attempting to reconnect from a sense of dissociation that stems from a history of trauma or abuse.

After first hearing about NSSI among otherwise functional, nonclinical adolescents more than a decade ago, Whitlock launched epidemiological studies, founded CRPSIR and brought together colleagues to form the International Society for the Study of Self-Injury in 2006. “Now we have so much literature coming out, I can’t keep up with it,” she said. But research on techniques for intervention in schools and families is still nascent, and findings do not always reach those in need.

“When I give presentations in schools, even elementary schools, I can pack a house talking about self-injury – it’s really pretty sad,” said Whitlock. “People come up to me asking for follow-up information. Clearly we need another dissemination vehicle.”

Paul Krause ’91, CEO of eCornell and associate vice provost for online learning, agreed: “We quickly recognized that it would make sense to work together because eCornell has all the capabilities to support the development, delivery and marketing of an online NSSI course.”

Best known for its professional development courses in such areas as marketing, finance and hospitality, eCornell also applies its experience and best practices to specialized curricula such as Whitlock’s to extend research-based education to learners beyond Ithaca.

Some 40 participants have enrolled since the first, self-paced version of the NSSI 101 course launched in February. This month, Whitlock is facilitating co-experts on NSSI by teaching the first iteration of a three-week version that offers eight to 10 hours of interactive instruction and continuing education credits. Shorter, abridged courses are also in development for medical professionals and parents of children who self-injure.

“This is an exciting opportunity for us,” said Krause, under whose leadership eCornell doubled the number of faculty members it works with to more than 100 over the past year. “We have faculty who are leading experts in their fields. eCornell’s mission is to help them use online learning to reach people all over the world.” (Whitlock’s first registrant was from South Korea.)

“The audiences with whom we seek to engage – be they parents, educators or others – need information that is high-quality, based in sound research, is compelling and that they can access on their own schedule,” added Rachel Dunifon, associate dean for research and outreach in the College of Human Ecology. “Working with eCornell to deliver research-based programming allows us to take a cutting-edge approach to our public engagement mission, broadening our reach and enhancing our impact as we seek to fulfill our college mission of improving lives.”

Misconceptions and misinformation about self-injury can keep sufferers from getting care and effect how they are treated by others. A recent US News & World Report article addresses some common myths about self-injury, including that self-injurers are suicidal, that self-injury is uncommon, and that the behavior is untreatable.

If someone becomes suicidal, then the act of having engaged in self-injury does psychologically prepare them to damage their body. That piece, for somebody who's never hurt their body before, is not easy. We have a lot of inner safeguards, psychologically, from taking our own lives. Somebody who really wants to commit suicide is going to have to overcome that. And somebody with self-injury has already practiced hurting themselves that way.

This September, the ACT for Youth Center of Excellence (COE) sponsored Provider Day 2014, a professional development conference for 224 teen pregnancy prevention program staff from communities across New York State. The COE provides technical assistance, training, and evaluation for three pregnancy prevention initiatives funded by the New York State Department of Health. Sex educators and youth service professionals from each initiative came together in Albany to share and gain new insights, strategies, and tools to promote healthy development among youth.

I found the day valuable and validating. I believe we need all the validation we can get when working in this field. It's not easy, and when we can recharge and gain new knowledge and tools, I know that I come back to the office looking for ways to use the information I have gotten. Thank you!